Organization
SNK THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANTA NISHI KANUKOLLU PHD (CLINICAL PSYCHOLOGIST)
(773) 270-2360
Entity
Organization
Contact information
Practice address
500 N MICHIGAN AVE STE 1042, CHICAGO, IL 60611-3783
(773) 270-2360
Mailing address
500 N MICHIGAN AVE STE 1042, CHICAGO, IL 60611-3783
(773) 270-2360
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
071.008400
IL
Other
Enumeration date
06/13/2017
Last updated
06/15/2017
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